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X06/05/2004 SAT 4;51 FAX 209 2999 SJC PUBLIC WORKS X003/003 <br /> EHD LOG NUMBER <br /> DA o NED <br /> EIIIII c�I SAN JOAQUIN COUNTY <br /> U ENVIRONMENTAL,HEALTH DEPARTMENT <br /> 304 E Weber Ave 3r1 Floor Stockton,CA 95205 <br /> JUN .0 4PM468-3420 Fax: (209)464-0138 Web:www.co.san joaquia_ca.us/ebd <br /> EfJVIRONMENT HEALT PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Wendy Johnson BUSINESSIAGENCY: San Joaquin County Public Works Department <br /> ADDRESS: 1810 E. Hazelton Avenue, Stockton, California 95205 <br /> PHor1_; 468-3085 FACSIMILE: 468-2999 <br /> TENTATIVE*APPOINTMENT DATE: Tiara: <br /> (Please allow 10 business days from date of appl(catlon subMi'dal) <br /> CHECK BOX TO ExpEWE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE t°' y • D�' <br /> Depertrr=t Use Only <br /> FILE ADDRESS UNIT <br /> I W.14owo-fd 9d �"tV Unit 1 <br /> s son ver. <br /> AplVatj to Unite _(�� <br /> 4. sVN9l l0 2 �• 1r A <br /> c. sova, 1 17� W Howard Pa I Unit 3 �j <br /> Milt <br /> !0 2 2 H " Unit 4,4 soK 94 7 . eld nit 5 <br /> 9230 W. ( Ward / <br /> ENVIRONMENTAL_HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATF-ME14T SOUD WASTE FAWASTE Q <br /> �( OTHER CL.VANUP SITE(NONI.OP) FOOD FACILITY L7 <br /> UNDERGROUND TANK(IRONrr0R1NG/REMOVAL) ❑ DOG KENNEL L15LDAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERJ<ARTED FAC1LtTY ❑ MOTEL MOTEL ❑ PUMPER TRUCKlYARDfCHEM TOILETS <br /> ❑ TATTOOBOpYPIEftCING ❑ POOUISPA JIZLAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the. <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHD s exist. An appointment for review will be confirmed <br /> Me-5 <br /> approximately five business days but no later than.ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> .6. Applications received after 3:00 pm will be processed the Next business day. <br /> Flo"424M~ <br /> &W26*3 <br />